Biomarkers of Major Depressive Disorder: Knowing is Half the Battle

Major depressive disorder (MDD) is a heterogeneous disease which is why there are currently no specific methods to accurately test the severity, endophenotype or therapy response. This lack of progress is partly attributed to the complexity and variability of depression, in association with analytical variability of clinical literature and the wide number of theoretically complex biomarkers. The literature accessible, indicates that markers involved in inflammatory, neurotrophic and metabolic processes and components of neurotransmitters and neuroendocrine systems are rather strong indicators to be considered clinically and can be measured through genetic and epigenetic, transcriptomic and proteomic, metabolomics and neuroimaging assessments. Promising biologic systems/markers found were i.e., growth biomarkers, endocrine markers, oxidant stress markers, proteomic and chronic inflammatory markers, are discussed in this review.Several lines of evidence suggest that a portion of MDD is a dopamine agonist-responsive subtype. This review analyzes concise reports on the pathophysiological biomarkers of MDD and therapeutic reactions via peripheral developmental factors, inflammative cytokines, endocrine factors and metabolic markers. Various literatures also support that endocrine and metabolism changes are associated with MDD. Accumulating evidence suggests that at least a portion of MDD patients show characteristics pathological changes regarding different clinical pathological biomarkers. By this review we sum up all the different biomarkers playing an important role in the detection or treatment of the different patients suffering from MDD. The review also gives an overview of different biomarker’s playing a potential role in modulating effect of MDD.

Determining the Neurocognitive Status and the Functional Ability of Patients to Screen for HIV-Associated Neurocognitive Disorder (HAND)

BACKGROUND AND PURPOSE: To adequately evaluate the extent of neurocognitive impairment in patient living with human immunodeficiency virus (PLHIV), a battery of neuropsychological tests is typically administered which are neither cost effective nor time efficient in the outpatient clinical setting. The aim of the study was to assess neurocognitive status and functional ability of people living with HIV and find a brief screening tool to identify those who would benefit from a full diagnostic evaluation.METHODS: The study enrolled 160 PLHIV (80 pre-antiretroviral therapy [ART] and 80 on ART) fulfilling the inclusion and exclusion criteria. Neurocognitive assessment and an assessment of Functional ability was done by using the Montreal Cognitive Assessment (MoCA) and Lawton and Brody Instrumental Activities of Daily Living Scale scale, respectively.RESULTS: The study population consisted of 75.6% males and 24.4% females with mean age of 44±10 years. The overall prevalence of HIV associated neurocognitive disorder (HAND) in the study subjects was 52.5%. Of these, 47.5% had asymptomatic neurocognitive impairment and 5% had minor neurocognitive disorder. In MoCA, the most frequently affected domains were Language (97.6%), visuospatial ability (92.9%) and memory (71.4%).CONCLUSIONS: The prevalence of HAND in both groups were similar suggesting that neurocognitive impairment starts early in HIV infection. Memory and Visuospatial function impairment had the most predictive potential for detecting the presence of HAND. HAND screening is recommended in all PLHIV at enrolment into care. Simple tools like MoCA can be used in busy outpatient settings by healthcare workers to screen for HAND.

An evaluation of the in-patient feedback services in a tertiary care hospital of Northern India

Background: Patient satisfaction is an important indicator of the quality of services provided by any healthcare organization and directly or indirectly affects patient retention, legal issues, revenues, reputation and success of a healthcare organization. Patient’s feedback about the clinical as well as non-clinical services can be recorded for gap analysis and improvement of services.Methods: The cross-sectional study was carried out in a large tertiary care hospital in North India from May 2012 to December 2012. A pre-tested internally developed questionnaire was used to collect the data.Results: It was observed that the average satisfaction score was relatively high for the criteria like doctor’s counselling, attitude of nurse and availability and behaviour of attendant. The average scores for medical and nursing care (clinical services) provided in wards were high (70-74% satisfaction). However, approximately 45% and 50% patients were dissatisfied with the housekeeping and dietary services respectively. This resulted in a dip in the overall impression of the hospital services to 68%.Conclusions: The percentage of patients satisfied with the overall services (clinical and non-clinical) of the hospital is only 68% which goes on to prove that the patients’ perception of quality is changing with the times and non-clinical areas like housekeeping, dietary, billing, security services are becoming as important as clinical care services that are provided by hospitals.

Psychosocial impact of acne on quality of life in north India: a hospital-based cross-sectional study

Objective: To evaluate the level of impact among acne patients on their quality of lifestyle and emotional well-being and to highlight the wider spectrum of problems that the patients face with acne

Methods: A total of 125 patients were enrolled for the study. Acne severity was graded using Global Acne Grading System [GAGS] after the clinical diagnosis. All the patients went through self administered questionnaire of Cardiff Acne Disability Index [CADI] to fill out, to assess the reflection of patients' experiences and perceptions

Results: Out of 125 patients, 72 [57.6%] were females and 53 [42.4%] were males. The age ranged from 14 to 38 years. The maximum number of patients was in the age group of 14-20 years [90/125, 72%]. Out of total 53 males, 33 [62.3%] had moderate to severe acne, whereas 58.3% females had such a severe acne. 47.2% [34/72] of females had high CADI scores in comparison to only 30.2% [16/53] of males. The impact on quality of life was more in the age-group of 21-30 years even though in this age group clinical severity of acne was mild to moderate only. According to duration of acne, patients having longer history of acne [>1 year] had highest CADI scores. There was significant correlation between severity of acne and CADI

Conclusion: We found compelling evidence that individuals with acne had profound emotional, as well as, social impact on their quality of life. Greater efforts are needed to improve physicianpatient communication while consultation, and provide more information to the patients. Patients should be managed rather than treated

Oral Implant Imaging: A Review

Selecting an appropriate implant imaging technique has become a challenging task since the advent of advanced imaging modalities, and many of these are used for implant imaging. On imaging, the modality should not only consider the anatomy but should also provide dimensional accuracy. Many dentists use the conventional method, mostly orthopantograph (OPG), in their routine practice of implant placement. However, because of the drawbacks associated with OPG, higher technologies, such as computed tomography (CT) and cone beam computed tomography (CBCT), are better accepted. These help improve image sharpness and reduce distortion. These techniques are not used widely due to the cost effect. Therefore, to decide on the type of imaging technique, all associated advantages and disadvantages should be considered, which will be broadly discussed in this review.

Effect of cigarette smoking on human health and promising remedy by mangroves

This article reviews the evils of cigarette smoking and the promise of mangroves to cure them. Chemicals in cigarette smoke are leading cause of death to both smokers and nonsmokers. Plant is the potential source to produce medicine for almost all the diseases. Mangroves are promising as a novel source of anti-cancer drugs in regulating the cancer pathways and stimulating immunity in the body system. Research on medicine from mangroves for the treatment of cancer has not only been shown to have an effect on cancer, but also provided important methods for the study of cancer therapy and mechanism. This report may help to explore the medicinal properties of the mangroves.

Molecular understanding of lung cancers-A review

Lung cancer is considered to be the most common cancer in the world. The purpose of this paper is to review scientific evidence, particularly epidemiologic evidence of overall lung cancer burden in the world. And molecular understanding of lung cancer at various levels by dominant and suppressor oncogenes.

Sildenafil improves six-minute walk distance in chronic obstructive pulmonary disease: A randomised, double-blind, placebo-controlled trial.

Background. Sildenafil has been found to improve exercise capacity and haemodynamic parameters in patients with various pulmonary disorders. This study was undertaken to evaluate its efficacy in severe chronic obstructive pulmonary disease (COPD). Methods. In this double-blind, randomised, placebo-controlled study, 37 patients with severe COPD received either sildenafil or placebo for 12 weeks. Distance covered in six-minute walk test (6MWD) was taken as primary end-point. Pulmonary artery pressure (PAP) was measured as secondary end point. Results. Thirty-three patients (15 in sildenafil arm and 18 in placebo arm) completed the study. Non-parametric tests were used for comparison. There was significant increase in 6MWD from baseline after three months of follow-up in sildenafil users (median change in distance covered in six-minute walk test (Δ6MWD)=190m) as compared to placebo users (Δ6MWD=0m, p< 0.05). The PAP decreased significantly (χ2=14.94, p<0.05) in sildenafil group after three months, while it did not change significantly among placebo group (χ 2=3.84, p>0.05). Conclusion. Sildenafil improved 6MWD and PAP in patients with severe COPD. This trial has been registered with Indian Council of Medical Research (ICMR) Trial Registry. [CTRI Registry Number: CTRI/ 2009/091/000017]